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Cluster and other trigeminal autonomic cephalalgias 

Cluster and other trigeminal autonomic cephalalgias
Chapter:
Cluster and other trigeminal autonomic cephalalgias
Author(s):

Arne May

DOI:
10.1093/med/9780199545148.003.0008
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date: 15 October 2019

Inflammation of the walls of the cavernous sinus, thought to obliterate venous outflow and thus injure the traversing sympathetic fibres of the intracranial internal carotid artery and its branches, is a controversial mechanism.

The least common denominator is that primary cluster headache is characterized by hypothalamic activation with secondary activation of the trigeminofacial reflex, probably via a trigeminohypothalamic pathway.

In longstanding chronic cluster headache, the headache and autonomic symptoms may be generated entirely through central mechanisms, and activation of the trigeminofacial reflex is no longer considered necessary to produce the full clinical picture.

The pain of cluster headache and the other trigeminal autonomic cephalalgias does not arise from a primary dysfunction of the trigeminal nerve itself but is generated directly from the brain.

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